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BackgroundBevacizumab is used in addition to standard, platinum-based chemotherapy to treat advanced-stage ovarian cancer patients. Thrombosis is a well-documented adverse effect of bevacizumab.ObjectiveThe aim of this study was to identify predictive parameters for thromboembolic events in ovarian cancer patients and to explain how bevacizumab increases the risk of these events.Patients and MethodsFifty-seven FIGO stage III ovarian cancer patients who underwent cytoreductive surgery and chemotherapy were identified and included in this retrospective study. Twenty-six patients were treated with carboplatin and paclitaxel (CP) only (control group), and 31 patients received CP with bevacizumab (study group). The two groups were compared with regard to thrombosis risk factors and laboratory parameters (total leukocytes, platelet count, hemoglobin, APTT, prothrombin time, INR, fibrinogen levels, D-dimer concentration) before treatment, after each course of chemotherapy, and during thromboembolic events.ResultsOnly patients in the group receiving bevacizumab experienced venous thromboembolism (VTE) (p=0.03, χ² test). VTE occurred on average at the 13th cycle of chemotherapy. Patients who experienced VTE had increased BMI before chemotherapy as compared to patients with no thromboembolic event (27.2 vs. 23.3, p=0.005, Mann-Whitney test). D-dimer concentration before treatment was also elevated more in patients affected by VTE (3132.5) than in the non-VTE group (956.43) (p=0.0007, Mann-Whitney test). During the first four administrations of chemotherapy in patients with future VTE, there was a reduction in D-dimer concentration and an extension of APTT. A D-Dimer level higher than 485 ng/mL prior to first chemotherapy indicates for a risk of VTE with 94% sensitivity and 36% specificity.ConclusionsAn elevated D-dimer level and high BMI before chemotherapy are risk factors for VTE in ovarian cancer patients receiving bevacizumab. Bevacizumab possibly increases the risk for VTE.

Introduction. Alcohol, together with drug use such as marijuana, is a major health concern that may influence the life of both doctors and medicine students. It is therefore important to investigate their habits associated with those hazardous behaviors.Material and methods. A voluntary survey containing 12 questions regarding their drinking habits and marijuana use was sent to law and medicine students from two cities in Poland, Poznan and Lublin. 814 responses were collected and the results were compiled using STATISTICA 10 program.Results. Mean age of alcohol initiation was revealed to be very similar in all groups at below 16 years of age. Although majority of students drink less than once a week (41% male and 65.7% female), men were found to use alcohol much more frequently and in higher quantities than female students. Half of future doctors would stop at the lowest stage on a proposed alcohol intoxication scale, while 11.6% would venture to the highest, third one. Those values for law students were 36.2% and 26%, respectively. 70% of men and 52.9% of women have tried marijuana. Majority of them smoke less than once a month, but almost a quarter of law students and 15% of medicine students do it at least once a month.Conclusions. More emphasis should be put on educating future doctors and general public about dangers associated with hazardous drinking and cannabis use. Prevention of such behaviors should be conducted at an age as young as possible.